New Biopsy Technique for Uveal Melanoma

Uveal melanoma is the most common primary malignancy of the eye and is one of the few fatal
diseases that are detected initially through an eye examination. For many years, clinical
decision-making regarding which patient with uveal melanoma required treatment has been
based solely on clinical features observed at the time of diagnosis. These features include:
tumor size as measured by ultrasound, associated subretinal fluid, presence of orange
lipofuscin pigment, lack of drusen, posterior location, and ciliary body involvement. All of
these clinical features have been demonstrated to be associated with tumor growth which is
associated with the eventual development of metastases. However, these clinical features are
not adequately sensitive or specific enough to predict which patients will develop
metastases.

More recently, researchers studying the genomics of uveal melanoma have focused on
identifying genetic abnormalities present in tumor tissue in order to characterize these
lesions more fully. Several landmark papers over the past 15 years have reported cytogenic
and genomic abnormalities in uveal melanoma tumor tissue that are associated with a poorer
prognosis. Although rare, there have been at least five cases in which patients undergoing
biopsy of these lesions have developed extraocular spread of melanoma from the biopsy sites.
With this new technique, the possible rate of extraocular spread should be lower, making the
biopsy a safer technique than what is currently in practice.

Inclusion Criteria:

- Diagnosed with uveal melanoma

- Scheduled for enucleation surgery

Exclusion Criteria:

- Patients under 21 years old

- Patients unable to undergo surgery

- Patients with known metastatic uveal melanoma or other cancer.